Lancet

The headquarters of the Royal College of Surgeons of England (RCS England) in London, UK, is a building that is designed to impress. Portraits of past RCS Presidents, most of them white men, stare down from an imposing staircase. Immediately in front is a da Vinci surgical robotic system, while beyond is the entrance to the Hunterian Museum. The objects in the museum are rooted in the 18th-century collection of John Hunter (1728–93), but alongside the history of surgery and human anatomy the displays also examine surgery in the 21st century.

After years of iterative refinements, drug-eluting stents (DES) have become the standard for percutaneous coronary intervention (PCI). 1-year rates of revascularisation and thrombosis with newer-generation DES are reported to be around approximately 3% and 0·5%, respectively, setting a high benchmark.1 However, DES still have limitations that raise concerns over a patient's lifetime. Their permanent metallic structure interferes with coronary artery angulation and dynamics, disrupting physiological properties such as vasomotion and adaptive remodelling.

Among patients with coronary artery disease, including those with acute coronary syndrome, treatment with the bioadaptor was non-inferior to contemporary DES, showing potential to mitigate non-plateauing device-related events and improving outcomes in patients undergoing PCI. The additional planned follow-up will help to reinforce the clinical significance of the 1-year findings.